PI's Weekly Media Digest: Opioids declared a public health emergency; nurses raise red flag on living conditions in Puerto Rico and call for more aid

PI Communications Team

October 27, 2017

Welcome to our media digest for the week of October 27, 2017! Each week PI compiles a round-up of the latest public health-related news, with an eye toward media framing and language, particularly as they relate to the role of primary prevention. The views expressed in these articles do not reflect those of Prevention Institute.

The Trump administration has declared the opioid epidemic a public health emergency, a long- awaited move that makes it possible to direct more resources to address the problem. The declaration does not, however, directly make funds available. According to USA Today, declaration will:

enable federal and state governments to shift grant funds for people with HIV/AIDS to provide substance abuse treatment;

make dislocated worker grants available to people in treatment for opioid use;

make it possible to tap into the Public Health Emergency Fund.

But the Public Health Emergency Fund contains a scant $57,000, and will require additional resources for a meaningful response. Some Democratic lawmakers and public health advocates noted that the declaration was not accompanied by a request to Congress for emergency funding, The Washington Post reported. In July, the commission that President Trump convened to address opioid misuse, the leading cause of death of people under 50 in the US, recommended declaring an emergency under either the Stafford Act, which would provide Federal Emergency Management Agency (FEMA) funds, or under the Public Health Service Act, which does not directly result in the release of public funds. The Administration indicated it chose the Public Health Service Act because FEMA funds are normally used for regional responses to natural disasters. One public health expert criticized the scale of response: “The house is on fire and they turned on the sprinkler system rather than the fire hydrant.”

The New Yorker’s Faces of an Epidemic offers glimpses into the devastating toll of the opioid epidemic in Montgomery County, Ohio, with a series of photos, including emergency responders reviving young men from overdoses, a crowded morgue, and a family parting with the body of their son and brother. His mother said. “The boys would tell me every day about somebody they went to high school with who died that day. That whole generation’s getting wiped out.”

A damning exposé published this week in the New Yorker details how the pharmaceutical industry at large – with the Sackler family and Purdue Pharma, makers of OxyContin at the helm – “shifted the culture of prescribing” by funding junk science, suppressing evidence of its products’ health harms, infiltrating doctors’ peer networks and trusted medical journals and exploiting doctors’ misconceptions to push them to prescribe opioids like OxyContin widely and heavily, all the while ignoring the signs that their dangerous product and irresponsible actions were fanning a national epidemic of opioid misuse and overdose deaths. Warning signs that addiction was taking root emerged almost immediately but, for decades, Purdue Pharma has taken the approach that OxyContin misuse and overdoses are a matter of personal responsibility, while behind the scenes arguing that their products are inherently vulnerable to abuse to stave off competition from generics.

Health officials are concerned that rural regions that are deeply affected by the opioid epidemic may next experience a surge in HIV cases that they’re not equipped to address, Brianna Ehley reports in Politico. Opioid users are turning to intravenous drug use, which can contribute to the spread of HIV, and many of the rural counties where drug use is on the rise do not have regular screening and prevention programs in place. Ehley writes: “The prospect that HIV is transforming itself from a disease that primarily affected gay men and minorities in urban centers to one that targets rural, red-state America could have huge political, as well as public health implications.” Meanwhile, in Vox, German Lopez reports that a county in Indiana has cut off a needle-exchange program on “moral” grounds, citing Biblical text as a rationale.

The Washington Post noted that, “despite how much the current conversation has centered on rural, white Americans, the impact of the drug is not limited to those spaces. Opioid addiction is more widespread ethnically and geographically than some Americans realize. Outreach workers in urban areas told PBS while funds and attention have been directed to white opioid and heroin users in suburbs, they struggle to get resources to help people of color fighting the same addiction.”

The American Public Health Association has produced an interactive overview of the protections at risk when lawmakers consider cutting the Prevention and Public Health Fund as part of the effort to repeal or replace the Affordable Care Act. Everything from suicide prevention to substance misuse screening and treatment to vaccines for children is in jeopardy.

Immigration and Customs Enforcement has detained a 10-year-old girl with cerebral palsy, who was first identified as undocumented when the ambulance carrying her to an emergency gallbladder surgery was stopped at a Border Patrol checkpoint. “Her placement there highlighted the unusual circumstances of her case: The federal government maintains detention centers for adult immigrants it plans to deport, facilities for families who arrive at the border together and shelters for children who come by themselves, known as unaccompanied minors. But it is rare, if not unheard-of, for a child already living in the United States to be arrested — particularly one with a serious medical condition.”

As the “Weinstein effect” continues to spread across high-profile industries, especially media and entertainment, the Atlantic reports on the pervasiveness of sexual harassment faced by less visible low-wage workers, especially those working in the service industry and in industries dominated by male employees.

Volunteer nurses from National Nurses United returned to the US this week, decrying the extreme conditions Puerto Ricans continue to face five weeks after Hurricane Maria struck. According to Vox, “the nurses described doctors performing surgery in hospitals with light from their cellphones, children screaming from hunger, elderly residents suffering from severe dehydration, and black mold spreading throughout entire communities. ‘We cannot be silent while millions of people continue to endure these conditions,’ said Bonnie Castillo, associate executive director of National Nurses United. She said some nurses arrived in towns that never got food or water supplies, or any other help from the Federal Emergency Management Agency. Some communities the nurses visited that did get supplies were not getting enough.”